compass - arizona state universitycompass after the dementia diagnosis. after the diagnosis • what...
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COMPASSAfter the Dementia Diagnosis
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After the Diagnosis
• What is dementia / Alzheimer’s Disease?
• Progression & Treatment
• Common Problems and Solutions
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Dementia
• General term that describes a category of diseases that result in impairment of:– Memory– Language– Personality– Behavior– Judgment
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Progression of Dementia
• Typically 7-10 years
• Stages:• Early (Mild) • Middle (Moderate) • Late (Advanced)
• Requires different services & strategies along the way
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Early Stage
• Short-Term Memory Loss
• Executive Function
• Problems with language
• Disorientation of time
• Emotions
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Middle Stage
• Memory
• Communication
• Senses
• Impaired judgment & problem solving
• Changes in personality & behavior
• More dependent with self care tasks
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Late Stage
• Severe memory loss
• Communication
• Orientation only to self
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TreatmentCholinesterase Inhibitor•Aricept/donepezil•Exelon/rivastigmine•Razadyne/galantamine
Chronicconditions
Depression
Early Stage Cholinesterase
inhibitor
NMDA Receptor Antagonist•Namenda/ memantine
Chronicconditions
Mood/ behavior
Middle Stage NMDA
receptor antagonist
Mood/ pain/ comfort
Hospice care
Late Stage
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Common Problems & Solutions
• Fatigue• Change• Too Much Demand
• Overwhelming / Misleading Stimuli• Communication• Activities• Illness
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Fatigue
• Problem:– More energy for same tasks
• Solutions:– Provide plenty of rest/ rest
periods– Shorten activities– “Best time of day”
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Change
• Problem:– Loss of ability to plan & sequence
activities– The world becomes less familiar
• Solutions:– Be consistent
• Routine• Environment
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Too Much Demand
• Problem:– Information can be
overwhelming– Unrealistic expectations
• Solutions:– Announce only when & what is
necessary– Create positive moments
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Overwhelming / Misleading Stimuli
• Problem:– Brain’s ability to interpret
information has become damaged
• Solutions:– Never argue or orient to reality– Remove distractions– Consider what will work for them
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Communication
• Problem:– Ability to express and understand
has changed
• Solutions:– Respond to the emotion– Watch your non-verbals– Agree, Apologize, Distract– Therapeutic fibbing
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Activities
• Problem:– Lack of initiative– Decreased ability to engage– Loss of purpose
• Solutions:– Put it all together
• Manage fatigue• Incorporate routine
– Focus on pleasure– Look towards previous
hobbies/ routines
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Illness
• Problem:– Difficult to identify– Sudden change in behavior
• Solutions:– Call your medical provider
immediately.– Consider:
• Dehydration• Infection• Pain• Constipation• Medications
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